Return to Case List with Diagnoses or Case List as Unknowns

FALSE POSITIVE SENTINEL LYMPH NODES DUE TO SKIN CONTAMINATION (LOCAL ONLY)
Authored By: Keith Fischer and Xiaoni Hong.
Patient: 78 year old male
History: 78-year-old male with left lower abdominal melenoma.
Image Size:[small][as-submitted]

Fig. 1
anterior transmission image of the chest and abdomen

Fig. 2
Chest(on the left) and pelvis(on the right) demonstrating 3 sentinal nodes in the left axilla and left groin after cleaning the skin.
Image Size:[small][as-submitted]

Findings:


Radiopharmaceutical: Following sterile preparation of the melenoma site on the left lower abdominal wall, 0.61 mCi millipore-filtered Tc-99m sulfur colloid was injected in five separate intradermal aliquots.



Findings: Three left axillary lymph nodes (two marked on the skin) and four left inguinal (3 marked on the skin) are demonstrated.   Multiple other foci of activity are seen over the skin of the upper chest.


Diagnosis:

Teaching point: This is an example of skin contamination that can confuse the identification of sentinel lymph nodes. 
General Discussion: Contamination has to be recognized and appropriate steps taken to eliminate it (see fig. 2).  Usually soap and water can accomplish this, but products are available that have a higher Ph to remove some of the superficial skin so decontamination is more complete.
Comments:
No comments posted.
Additional Details:

Case Number: 82845Owner(s): Keith Fischer and Xiaoni HongLast Updated: 02-07-2013
Anatomy: Other   Pathology: Neoplasm
Modality: Nuc MedAccess Level: Readable by all users, writable by NucMed Certifiers
Keywords: lmnmACR: 90000.34000

Case has been viewed 45 times.
Certified by Keith Fischer on 01-27-2009

The reader is fully responsible for confirming the accuracy of this content.
Text and images may be copyrighted by the case author or institution.